Individual
DR. PETTER LEWIS OVERTON-HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7551
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7551
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
DO2022-0029
NM
207P00000X
Emergency Medicine Physician
Primary
DO214916
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2017
Last updated
07/06/2023
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